NSG 552 Exam 2 Study Questions with Verified Answers | Latest Edition

NSG 552 Exam 2 Study Questions with Verified Answers | Latest Edition 1. What is social phobia and how is it treated? - ANSWER fear of scrutiny by others or fear of acting in humiliating or embarrassing way CBT First line - SSRI or SNRI Benzos can be used as scheduled or PRN Beta blockers such as atenolol (50-100 mg) and propranolol (20-40 mg) 1 hour before performance or public speaking 2. What is used to great specific phobias? - ANSWER CBT with exposure SSRI - fluvoxamine (Luvox), Paxil (paroxetine), Zoloft (sertraline), SNRI - Effexor (venlafaxine) 3. What is obsessive compulsive disorder (OCD) and how is it treated? - ANSWER obsessions and/or compulsions that are time consuming, distressing, and impairing MEDS + CBT Fist line- SSRI (often high doses of Zoloft (sertraline). Prozac (Fluoxetine), Luvox - FDA approved (fluvoxamine) 50-300 mg 2nd line - SNRI Effexor (venlafaxine) TCA Anafranil (clomipramine) FDA approved Can augment with atypical antipsychotic in severe cases ECT in debilitating resistant cases 4. What is a common side effect of SSRI Luvox (fluvoxamine)? - ANSWER nausea and vomiting 5. What are commonly prescribed benzodiazepines? - ANSWER Alprazolam (Xanax) and lorazepam (Ativan) 6. What effects does GABA lead to? - ANSWER Potentiate effects of GABA (GABA is inhibitory and lead to drowsiness, cognitive impairments, dampening of fear and anxiety, impaired balance, motor control, muscle tone, and coordination, and anterograde amnesia 7. Who is at greater risk of fall risk and hip fracture on benzodiazepines? - ANSWER Elderly patients 8. What is the mechanism of action for benzodiazepines? - ANSWER enhance activity of GABA at GABA-A receptors 9. Why are benzodiazepines not always the best choice of medicatioon - ANSWER potential for abuse and addition may become physically dependent may build tolerance 10. What can be used to treat akathisia? - ANSWER Benzodiazepines can be used to treat the uncontrollable urge to move and fidgeting movements 11. How is choice of BDZ decised? - ANSWER time of onset, duration of action, and method of metabolism OTL = metabolized outside the liver (lorazepam, oxazepam, temazepam) 12. What are side effects of BDZ? - ANSWER anticholinergic (dry mouth, constipation, urinary retention, blurred vision, increased HR), unusual behavior4s, hallucinations, daytime drowsiness, amnesia 13. What is a known limitation of benzo - ANSWER rebound insomnia 14. What are benzodiazepines withdrawal symptoms? - ANSWER Similar to alcohol withdrawal insomnia, anxiety, hand tremors, irritability, anorexia, N/V, Autonomic hyperactivity (diaphoresis, tachycardia, HTN), tonic-clonic seizures which are life-threatening Abrupt abstinence after chronic use is life-threatening 15. How do you stop BZD? - ANSWER taper 10% total dose each week "Physical and behavioral taper: Common strategy to convert from SA to LA to facilitate more comfortable taper 16. What is the mechanism of action of buspirone (Buspar) - ANSWER Non benzodiazepine partial agonist at 5HT-1! = decreases serotonergic activity 17. Characteristics of Buspirone (Buspar) - ANSWER slower onset of action than benzos (takes several weeks) Augmentation with other agents such as SSRI Low potential for abuse/addiction Dosed 2-3 times per day NO PRN 18. What endocrine medical conditions mimic or worsen anxiety - ANSWER hyperthyroidism, hypothyroidism, Cushing's disease, Addison's disease, menopause pheochromocytoma 19. What cardiovascular medical conditions mimic or worsen anxiety - ANSWER acute coronary syndrome, arrhythmia, CHF, Hypertension, hypotension, mitral valve prolapse 20. What neurological medical conditions mimic or worsen anxiety - ANSWER epilepsy, cardiovascular disease, Meniere's disease, migraines, encephalitis, early dementia 21. What metabolic medical conditions mimic or worsen anxiety - ANSWER porphyria, diabetes 22. What pulmonary medical conditions mimic or worsen anxiety - ANSWER asthma, COPD, pulmonary embolism, pneumonia 23. What is PTSD - ANSWER the development of multiple symptoms after exposure to one or more traumatic events 24. What is the hippocampus? - ANSWER complex brain structure embedded deep in the temporal lobe that plays a major role in learning and memory